| NPI | 1578456687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: ND R49734) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251E00000X Home Health | |
| 163WC1500X Registered Nurse, Community Health (Licence: ND R49734) | |
| 251J00000X Nursing Care | |
| 251S00000X Community/Behavioral Health | |
| 251T00000X PACE Provider Organization | |
| 372500000X Chore Provider | |
| 373H00000X Day Training/Habilitation Specialist | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 3747A0650X Technician, Attendant Care Provider | |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2025-05-29 |
| Last Update Date | 2025-05-29 |